India's Hidden
Aids Epidemic
By Maxine Frith
The
Independent, UK
19 November 2003
When she was 21, Kousalya Periasamy was
forced into marriage with a man she did not like. She
was told she had to marry him because his family owned land that supplied
water to her father's factory. What Kousalya wasn't told was that her
husband was HIV positive.
"He knew he
was positive and his family knew too. I think my father suspected because
he knew what my husband was like, but the marriage was all to do with
money," Kousalya said.
"I knew nothing.
I didn't like my husband but he forced me to have sex with him and his
family said it was my duty. I became ill and my husband's family said
I should go for tests, and that is when I found out I was HIV positive."
Kousalya's story is tragically common in India, and goes to the heart
of its burgeoning Aids epidemic.
While the country
is becoming increasingly wealthy from foreign investment, and the growth
of call centres and its hi-tech industry, the status of women has remained
hugely unequal. Women have few rights to property, or control over whom
they marry. Rape within marriage is legal, and domestic violence is
condoned rather than condemned.
Low-caste women
are often forced into prostitution, and even those who are better off
can find it difficult to receive health care because they are put under
pressure not to leave the house alone.
Campaigners say
the inequalities are adding to the rapid spread of HIV and Aids. A report
by the British charity Voluntary Service Overseas, to be published this
week, will warn that unless women's rights are improved India could
face disaster.
The Indian government
insists that only 4 million people have HIV or Aids - about 0.4 per
cent of the population. But most aid agencies say the real figure is
much higher. The Centre for Strategic and International Studies in Washington
has estimated India will have 25 million cases by 2010.
While the West has
focused on Africa when dealing with the Aids epidemic, India has been
largely ignored. But as hospitals struggle to cope with the numbers
of sick patients, and the country opens its first Aids orphanages, the
Indian government is under increasing pressure to act.
Peter Piot, the
head of the UN Aids agency, recently told a conference in Delhi: "India
has a king-sized problem. But it is a problem with a solution. We can
act now before it is too late." According to the VSO report, Gendering
Aids, women's low status and lack of rights have left them vulnerable
to infection regardless of their own behaviour. Married men visit prostitutes,
putting their wives at risk of infection. Three quarters of HIV-positive
women have been infected within marriage. Even if a woman knows her
husband is infected, it can be impossible to insist he practises safe
sex. If they leave their husbands, women, in effect, forfeit their rights
to the marital home and the dowry they brought with them. As increasing
numbers of HIV-positive men are dying in India, young widows are finding
themselves forced out of their home by their husband's relatives.
While the government
has begun to respond to the Aids epidemic, it has done little to improve
women's rights. It has also banned discussion of condoms in schools
and colleges, despite the fact that many girls are married by the time
they are 16. Girls are traditionally not supposed to know anything of
sex or contraception before they marry.
Satish Kumar, an
education officer who works with the Aids group YRG Care in the southern
city of Chennai, said: "We need to be able to give teenagers information
about condoms. The government says that it will encourage them to become
promiscuous, but that is not true."
African countries
such as Uganda have cut HIV rates with a campaign known as ABC: Abstain,
be faithful or use condoms. VSO has started recruiting volunteers from
Uganda to work on HIV and Aids projects in India. In Africa, drug companies
have agreed to supply cheap anti-HIV drugs, but the deal does not extend
to India.
K K Abraham, of
the Indian Network of Positive People, said: "India has got to
go through a phenomenal social and economic change in the way we think
before we can deal with the Aids issue and see women as equals."
Attitudes are beginning
to change. Kousalya was so outraged at the way she was treated that
she set up her own support group, the Positive Women's Network, and
became the first woman in India to go public about having the virus.
Three years ago,
she was critically ill with HIV-related infections. Thanks to anti-Aids
drugs, she is now healthy and will travel to London for the launch of
the VSO report. "When I first got ill, I was very angry at my husband.
I thought I was going to die because Aids meant death, and life had
no meaning," she said. "Now I can look forward to the future.
I like to look after my nieces. I want India to change for them."